Gurney JK, et al. - Among a national prevalent cohort of patients with diabetes, authors intended to elucidate the postoperative mortality after lower-limb amputation. They also contemplated if postoperative mortality varied by demographic subgroup, patient morbidity level, and health system factors related to the facility in which the amputation occurred. Death was reported in more than 11% of patients who underwent major amputation within 30 days. On the other hand, nearly 18% died within 90 days. Findings demonstrated a high risk of postoperative mortality along with a differential risk of postoperative mortality via demographic subgroup.

Methods

• Researchers analyzed 302,339 subjects who were diagnosed with diabetes between 2005 and 2014 using national health data collections.
• The follow-up period was until the end of 2014 for major and minor lower-limb amputation and subsequent postoperative mortality.
• Kaplan-Meier survival analysis assisted in identifying the postoperative survival.
• In order to describe the relative hazard of postoperative mortality, adjusted for covariates, the Cox proportional hazards models were used.

Results

• The occurrence of 6,352 lower-limb amputations was reported over the study period (2,570 major amputations, 3,782 minor amputations).
• It was determined that within 30 days, more than 11% of patients who underwent major amputation died.
• Death was reported in nearly 18% subjects within 90 days.
• Among older patients and indigenous Maori, death was found to be most common.
• No consistent or significant relation was illustrated between sex, deprivation, rurality, hospital volume, admission type, and patient comorbidity with the risk of postoperative mortality.